For a moment, it looked like Maryland was going to open up the state’s affordable care act marketplace, known as the Health Benefit Exchange, to undocumented individuals to purchase independent health care plans. As it stands, only U.S. citizens or legal residents of Maryland are eligible to participate in the exchange which connects individuals to health care plans for purchase. That dream is dead for now after the state Senate did not advance the Access to Care Act by the end of Sine Die on Monday.
Instead, the Maryland General Assembly passed SB0806 which requires the Maryland Department of Health in collaboration with the health benefit exchange to study options for affordable health care and dental coverage for undocumented residents statewide. The findings from the studies need to be completed and returned to the General Assembly by October 31.
As of 2021, there are “an estimated 244,700 undocumented immigrants residing in Maryland, approximately 115,900 of whom are estimated to be uninsured,” according to the bill analysis.
It’s disappointing, says Ninfa Amador-Hernandez, a policy analyst with the Maryland branch of the immigrant rights’ group CASA.
“This is not a win. The immigrant community in Maryland is very disappointed, appalled about the actions, the inaction of the Senate,” she said, pointing out that the MBHE already conducted an affordability study for the Access to Care Act. “We already have data available. So we don't really need more studies.”
Sen. Clarence Lam, a Democrat representing parts of Anne Arundel and Howard Counties, who sponsored the Senate version of the Access to Care Act also expressed disappointment but did describe SB0806 as “incremental progress.”
“The report generated by SB806 will provide an even deeper roadmap for next steps to further expand health exchange subsidies to those who are undocumented,” Lam wrote to WYPR in an email, also adding that although it is too soon to know if the same bill will be introduced in the next session.
“We will certainly continue to strive to increase access and coverage for all Marylanders, including those who are vulnerable or undocumented,” he wrote.
Ultimately, after expressing qualms about the financial impact of the Access to Care Act, Senate Finance Committee Chair Melony Griffith (D- Prince George’s County) told Maryland Matters last week that it looked unlikely the bill would move out of committee.
“I appreciate the passion behind the issue,” Griffith said. “I share the desire to make health care available to our most vulnerable communities. But I don’t think we’re moving it this year.”
The MHBE estimated that the net cost to the state for the program would be $90.3 million and then increase up to $176.2 million for 2027– although the addition of new healthy individuals would cause premiums to decrease, they wrote.
The fight to expand affordable health insurance to all Marylanders, documented or not, is far from over, says Amador-Hernandez of CASA.
There are other options to insure undocumented people besides expanding the MHBE. In California, the state opened up Medicaid to cover undocumented people and that’s an option that CASA would support too, said Amador-Hernandez.
“We hope that this report may have more explicit concrete data that will move the legislature forward in the future,” says Amador-Hernandez. “These immigrants, these Marylanders are still suffering. So we still need access to care for them.”
